Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands 6009, Western Australia, Australia.
Int J Surg. 2009 Oct;7(5):424-7. doi: 10.1016/j.ijsu.2009.07.010. Epub 2009 Jul 26.
Splenic rupture secondary to colonoscopy was first reported in 1974 by Wherry and Zehner. It has an incidence of around 0.00005-0.017%, and a mortality rate of 5%.
We performed a literature search to identify the demographic profile, risk factors, clinical presentations, diagnosis and management of this rare complication.
There were 66 patients (51 females and 14 males), with a median age of 65. The mortality rate was 4.5%. Majority (n=41, 62.1%) occurred in uneventful colonoscopies. Symptoms usually (74%) occurred within 24h, and 55.8% presented within 24h. Majority (93.9%) had some form of work-up done, with blood tests (78.8%) and CT (68.2%) being the most frequent. Laparotomy and splenectomy were done in over half (56.1%) of the patients. Splenic hematoma (47%), laceration (47%) and rupture (33.3%) were the most common findings.
Splenic injury is an important complication to be aware of as its number will continue to rise with the increasing numbers of colonoscopies being performed for colorectal diseases, and delayed diagnosis may result in adverse outcome for the patient.
1974 年，Wherry 和 Zehner 首次报道了结肠镜检查引起的脾破裂。其发病率约为 0.00005-0.017%，死亡率为 5%。
我们进行了文献检索，以确定这种罕见并发症的人口统计学特征、危险因素、临床表现、诊断和治疗方法。
共有 66 名患者（51 名女性和 14 名男性），中位年龄为 65 岁。死亡率为 4.5%。大多数（n=41，62.1%）发生在无并发症的结肠镜检查中。症状通常（74%）在 24 小时内出现，55.8%在 24 小时内出现。大多数（93.9%）进行了某种形式的检查，其中血液检查（78.8%）和 CT（68.2%）最常见。超过一半（56.1%）的患者接受了剖腹手术和脾切除术。脾血肿（47%）、撕裂伤（47%）和破裂（33.3%）是最常见的发现。
随着结肠镜检查数量的增加，脾损伤作为一种重要的并发症，其数量也将继续增加，并且延迟诊断可能会对患者产生不良后果。
